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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2007 December;20(6):285-8
The effects of off-pump and on-pump coronary revascularization in severe left ventricular dysfunction
Özsöyler I. 1, Lafci B. 1, Emrecan B. 1, Tulukoglu E. 1, Kestell M. 1, Yilik L. 1, Yakut N. 2, Gürbüz A. 1
1 Department of Cardiovascular Surgery Atatürk Training and Research Hospital, Izmir, Turkey
2 Department of Cardiovascular Surgery Gazi Hospital, Izmir, Turkey
Aim. Impaired left ventricular function affects the short term mortality in coronary artery bypass surgery. But in these patients, left ventricular functions improve after the operation. We studied the early postoperative outcomes of on-pump and off-pump techniques in patients with left ventricular dysfunction.
Methods. We prospectively analyzed the data of 137 patients with left ventricular ejection fractions below 30%. There were 79 patients in the off-pump group and 58 patients in the conventional on-pump coronary artery bypass group.
Results. Mean age of the off-pump group was 65.77±9.83 years, whereas it was 61.31±9.74 years in the on-pump group (p=0.009). Preoperative characteristics of the groups were similar. The preoperative mean ejection fraction of the off-pump group was 25.08±4.20%. Mean ejection fraction of the on-pump group was 26.53±3.26%. Six patients died in the early postoperative period, 4 (6.8%) of which were in the on-pump group and 2 (2.5%) of which were in the off-pump group. Mean number of distal anastomosis was 1.91±0.89 in off-pump group and 2.55±0.95 in on-pump group (p<0.001). Postoperative echocardiographic evaluation of the patients in the 6th month of discharge displayed significant increase in the ejection fractions from 25.08±4.20% to 31.49±4.93% in the off-pump group and from 26.53±3.26% to 33.13±3.31% in the on-pump group (p<0.001). Early mortality ratios were similar in both groups. Need for blood transfusion, length of ventilator support and postoperative length of stay were significantly higher in the on-pump group.
Conclusion. Postoperative left ventricular ejection fraction ratios increased in both the off and on-pump groups.